Basic Information
| Provider Information | |||||||||
| NPI: | 1487897609 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAHIR | ||||||||
| FirstName: | FAIZA | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 590104 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772590104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814284024 | ||||||||
| FaxNumber: | 2814284026 | ||||||||
| Practice Location | |||||||||
| Address1: | 1602 W BAKER RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | BAYTOWN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775212282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814284024 | ||||||||
| FaxNumber: | 2814284026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2009 | ||||||||
| LastUpdateDate: | 12/17/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RI0200X | N7884 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 300749401 | 05 | TX | MEDICAID |